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received a stress fracture in my femoral neck 7 years ago,

 
Dr. Arun Phophalia's Avatar
  • Answered by:Dr. Arun Phophalia
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Customer Question

received a stress fracture in my femoral neck 7 years ago, I have seen three different doctors regarding my pain that i have every day. pins and needles burning throbbing radiating sensation in both legs, Sharp or "electric shock" sensation in area surrounding injury. Burning aching tense in lower/upper back, tingling sensation in ankles and/or feet Weakness in the hip area and left leg.

Received three different diagnosis,mayofacial syndrome,nerve damage and Chondromalacia. Although all possible,I have yet to get a definite answer. I am only 30 years old and have been dealing with all this pain for seven year,im frustrated and tired. I need some answers and help please.

 

Optional Information:
Person's Gender: Female
Person's Age: 30

Already Tried:
MRI,xrays,medication for nerves (gabatin 100mg),600mg ibprothin,physical therapy,and muscle relaxers.

Submitted: 312 days and 15 hours ago.
Category: Health
Value: $18
Status: CLOSED
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Expert:  Dr. Arun Phophalia replied312 days and 15 hours ago.

Greetings.

I am sorry about your prolonged persistent symptoms.

What did your pelvic MRI and nerve conduction velocity study show?

Dr. Arun

Customer replied312 days and 9 hours ago.

MRI is normal,and don't think I ever revived a nerve conduction velocity
study. All the Dr. do what a few stretches,he indicated since I had no
sharp pain with the stretches it could not be nerve damage. He also took me
off of the gabatin (nerve blocker)

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Expert:  Dr. Arun Phophalia replied312 days and 4 hours ago.

Hello Melissa,

Since your symptoms have been going on for very long time; reinvestigation as following would be recommended for ascertaining the cause;

1) Nerve conduction velocity study (NCV).
2) MRI of the pelvic floor and lower back.

A Piriformis syndrome can be the possibility with your symptoms. A thorough medical history and physical examination by MD in physical medicine and rehabilitation specialist, are essential to proper diagnosis. Diagnostic testing may be used to differentiate piriformis syndrome from other causes of radiculopathy. This article reviews the pathophysiology and management of piriformis syndrome.

 

http://www.ncbi.nlm.nih.gov/pubmed/9001677

 

Following is the comprehensive treatment;

 

1) passive stretching of the piriformis muscle after application of sprayed vapocoolant.

2) physical therapy; simple muscle stretch, augmented muscle stretch, post-isometric relaxation.

3) deep electrotherapy; iontophoresis, phonophoresis, short wave diathermy, electrical stimulation, high voltage galvanic stimulation, biofeedback.

4) local analgesic patch / ointment / spray

5) anti-inflammatory analgesics; Ibuprofen (Motrin / Advil)

6) ischemic compression therapy; pressure on the points

7) massage

8) steroid shots

9) acupuncture

 

This is the resource where you can learn the piriformis stretch;


http://sportsmedicine.about.com/od/flexibilityandstretching/qt/Piriformis_str.htm


Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

 

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Customer replied311 days and 15 hours ago.

,Would this condition also affect my back? There is also a cracking/popping noises in my left hip neck and back when I wake up in the morning. The tingling and burning sensation is constant in my legs,and more intense when I sit or lay down. Yes,it is very painful to sit for a long Time and my feet hurt /feel swollen when I stand to long.

Accepted Answer

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Expert:  Dr. Arun Phophalia replied311 days and 15 hours ago.

Hello Melissa,

Yes, this can affect the back too. There can be concomitant degenerative disc disease too. Following comprehensive measures would be helpful;

1) Back care in the activities of daily living, which is an integral component of the treatment of back problems. Back education is one of the most important thing which teaches the basic body mechanics, like correct posture for standing, standing at a desk or drawing board, sitting, brushing teeth, washing the face, pushing and pulling a weight, lifting a weight, getting in and out of bed, sleeping, getting into and sitting in a car. The training for these routine activity helps in preventing the spasm of the muscles. One needs to consult an occupational therapist or physical therapist which can educate about the proper and improper behaviors when back is painful in case they have to sit, bend forward, lie down, walk, cough, or sneeze. Following more need to be done:

 

a) Avoid activities which increases the pain.

b) Rest intermittently

c) Avoid bending at 90 degrees

d) Pushing and pulling should be avoided till pain subsides

f) Avoid prolonged sitting and standing

g) Avoid sitting or sleeping on floor

 

2) Anti-inflammatory analgesics like ibuprofen, other analgesics and muscle relaxants

 

3) Local analgesic gels or sprays / ointment

 

4) Hot fomentation

 

5) Electrotherapy like trans cutaneous electrical nerve stimulation: done by physical therapist. Other thing are ice packs, heating pads, electrical stimulation, phonophoresis, iontophoresis, relaxation, and biofeedback.

 

6) Good supervised physiotherapy: The exercises consist of abdominal bracing, modified sit-ups, double-knee-to-chest or low back stretches, seat lifts, mountain and sag exercises, knee-to-elbow exercises, hamstring stretches, extension exercises, and extension flexibility exercises. Swimming exercises (pool exercises) are best for back pain. Initial stretching and later strengthening exercises are taught.

 

7) Lumbosacral corset or support or brace

 

8) If obese or over weight, reduce weight for long term benefit.

9) Epidural steroid shots

 

10) You can start the following exercises;

 

1) Straight leg raising: Lie on the bed with your back and remain in a relaxed position. Slowly raise one of your legs upward and keep it as straight as possible. Count up to ten, and slowly bring down the leg. Do the same with the other leg. Repeat this exercise ten times.

 

2) Curl ups; lie on the back with knees bent, fold arms across the chest, tilt the pelvis to flatten the back, and curl-up lifting the head and shoulders from the bed / couch. Hold for ten seconds, then slowly lower to starting position. As strength builds, aim to complete one sets of ten curls. The exercise should be done twice a day (both the sets).

 

This is a slide show for the exercises (you can pick up your own set, which suits you);

 

http://www.mayoclinic.com/health/back-pain/LB00001_D

 

You can consult following specialists;

 

a) Orthopedist

b) MD in Physical medicine and rehabilitation

 

Expert TypeDoctor (MD)
Category: Health
Pos. Feedback: 98.6 %
Accepts: 15717
Answered: 8/10/2012

Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine

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